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1437312931 NPI number — KELLEY STEPHENS SCHROTH MD

NPI Number: 1437312931
Health Care Provider/Practitioner: KELLEY STEPHENS SCHROTH MD

Information about “1437312931” NPI (KELLEY STEPHENS SCHROTH MD) exists in 1437312931 in HTML format HTML  |  1437312931 in plain Text format TXT  |  1437312931 in PDF (Portable Document Format) PDF  |  1437312931 in an XML format XML  formats.

NPI Number : 1437312931 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1437312931",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SCHROTH",
    "FirstName": "KELLEY",
    "MiddleName": "STEPHENS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STEPHENS",
    "OtherFirstName": "KELLEY",
    "OtherMiddleName": "ELIZABETH",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "201 HOSPITAL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CANTON",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30114-2408",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "770-720-5100",
    "MailingAddressFaxNumber": "404-851-6325",
    "FirstLinePracticeLocationAddress": "1000 JOHNSON FERRY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30342",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-851-8000",
    "PracticeLocationAddressFaxNumber": "404-303-3759",
    "EnumerationDate": "07/03/2008",
    "LastUpdateDate": "05/19/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "01080558A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "071024",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "01080558A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "071024",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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